Study Reviews Cecal Cupula Impaction Colic (AAEP 2012)

The treating surgeons considered surgery successful in all seven horses that survived to hospital discharge, and these animals had "excellent long-term survival."

Photo: Anne M. Eberhardt/The Horse

The horse’s cecum holds 25-30 liters and allows a horse to digest the cellulose in his forage. Like other parts of the intestine, the cecum can become impacted, and rupture can occur with little warning. The cecal cupula (the cranial, or closest to the head, portion at the base of the cecum) can become impacted as well, but until recently these uncommon impactions had only been reported in conjunction with other cecal problems.

At the 2012 American Association of Equine Practitioners’ Convention (AAEP), held Dec 1-5 in Anaheim, Calif., Ceri Sherlock, BVetMed, MS, Dipl. ACVS, MRCVS, of Bell Equine Veterinary Clinic, in Kent, U.K., presented a retrospective study of cecal cupula impactions occurring in seven horses treated at the University of Georgia with no other signs of cecal disease.

Sherlock and her colleagues evaluated records of seven horses that were seen over a 10-year period with cecal cupula impaction as the primary problem. In other words, the horses had no impactions in the remainder of the cecum, no obvious predispositions to cecal disease, and no other abdominal lesions.

The horses ranged from 2 to 23 years old and were of varying breeds and weights. Most were male. Three horses had histories of recurrent colic, and three had a history of weight loss. Four had consumed a diet of coastal Bermuda grass hay, while the remaining three had eaten primarily alfalfa hay.

The average duration from the onset of clinical signs to referral was 43 hours, suggesting that the horses’ initial pain was fairly mild. Indeed, even after reaching the referral facilities, the average time to elapse before surgery was a total of 47 hours. All horses had normal bloodwork parameters and did not show signs of shock or septic infection. The treating surgeons considered surgery successful in all seven horses that survived to hospital discharge, and these animals had “excellent long-term survival.”

Sherlock and colleagues noted that some of these horses remained fairly stable for several days between the onset of signs and surgery. They discussed that, in theory, this condition might have been able to be treated medically for longer and might have even resolved without surgery. However, she noted, they considered it in the horses’ best interests to intervene surgically after one to four days of hospitalization and intensive care, as the horses were showing no signs of improvement. They did note that horses with cecal cupula impaction survived and returned to normal function very well following surgery.

Sherlock noted that further research is needed to identify and confirm predispositions to cecal cupula impactions. She suggested that researchers at a variety of institutions should work together to complete further studies to gain more knowledge about this rare condition.

About the Author

Christy Corp-Minamiji, DVM, practices large animal medicine in Northern California, with particular interests in equine wound management and geriatric equine care. She and her husband have three children, and she writes fiction and creative nonfiction in her spare time.

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